We'll start with some news the administration made late this afternoon:

Trump officials make new moves to lower drug prices

A proposed rule from the Trump administration could completely upend the way Medicare beneficiaries purchase prescription drugs.

The proposal is targeting secretive rebates between drug manufacturers, insurers and pharmacy benefits managers as a way to lower drug prices for Medicare.

The details: The proposal would scale back the legal protections for prescription drug rebates, essentially eliminating them. According to the Department of Health and Human Services, the proposal would lower prescription drug prices and out-of-pocket costs by encouraging manufacturers to pass discounts directly on to patients at the point of sale.

"This proposal has the potential to be the most sweeping change to how Americans' drugs are priced at the pharmacy counter, ever, by delivering discounts directly to patients at the pharmacy counter and bringing much-needed transparency to a broken system," HHS Secretary Alex Azar said in a statement.

Is this a cost shift?In a way, but HHS says it will benefit all Medicare beneficiaries, especially those who use some of the most expensive drugs. Premiums for Medicare Part D will go up, but the argument is that drug companies will lower their sticker prices. So people will pay less at the pharmacy counter and people who use a lot of expensive drugs will pay a lot less.

Winners and losers:The proposal has been in the works for months, and the PBM industry is ready for a fight. From Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott: "We are concerned ... that eliminating the long-standing safe harbor protection for drug manufacturer rebates to PBMs would increase drug costs and force Medicare beneficiaries to pay higher premiums and out-of-pocket expenses."

But PhRMA is thrilled. For once, they're not the ones taking a hit.

"We applaud the Administration for taking steps to reform the rebate system to lower patients' out-of-pocket costs. Our current health care system results in patients often paying cost-sharing based on the list price, regardless of the discount their insurer receives," PhRMA president and CEO Stephen J. Ubl said.

Grassley said he asked several drug companies to testify, with all but two small companies refusing.

The chairman's request poses a tough choice for drug companies as they try to navigate congressional inquiries and risk being subpoenaed by lawmakers to force them into testifying.

Drug industry's perspective: "I can imagine it would be a pretty ugly call for the person from the Washington office who has to call the CEO and tell them they're going to [have to testify]," said Ian Spatz, a former vice president at Merck who is now a consultant at Manatt, Phelps & Phillips. "It's not something any CEO is going to be eager to do."

Spatz, though, said he expects that "over time ... it's going to happen and there will be CEOs that will appear."

What to watch: Will any drug companies agree to testify in the future when Grassley presses them again? Or will they be subpoenaed?

The embrace of "Medicare for all" legislation by top 2020 Democratic presidential candidates has opened up a rift in the party.

Democrats highlighted health care in the 2018 midterm elections and reclaimed the House majority. But their message was focused on protecting ObamaCare, not implementing a single-payer system -- which is favored by progressives.

Some on the left maintain that backing Medicare for all legislation is a must for anyone who wants to secure the Democratic presidential nomination in 2020.

Witnesses haven't been announced for either hearing, but Health and Human Services Secretary Alex Azar has already declined to testify at the family separation hearing.

AARP wants Trump to mention high drug prices during the State of the Union

"Prescription drug prices have reached a crisis point, with many Americans struggling to afford the medicine they need to stay healthy," AARP CEO Jo Ann Jenkins wrote in a letter to President Trump Wednesday.

"Next week you will speak to the nation in your State of the Union address. We urge you to use this opportunity to highlight the problem and talk about what your administration will be doing, and how you will work with Congress to combat the skyrocketing cost of prescription drugs."

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